A case of nephrotic syndrome (NS) with advanced uterine cancer, in which the patient's QOL was greatly improved by treatment of NS

It is not uncommon for edema in the end stage of advanced cancer to be caused by nephrotic syndrome (NS) as well as by cachexia, hypo-proteinemia due to malnutrition, or lymphedema. Such edema not only causes patients' quality of life (QOL) to be deteriorate, but may also result in earlier death in the absence of accurate diagnosis and treatment. We report a case of nephrotic syndrome with advanced uterine cancer, in which the patient's QOL was greatly improved by the accurate and timely diagnosis and treatment of NS. A 65-year old woman suffering from recurrent uterine cancer (lung and brain metastases) was admitted as an emergency due to deterioration of her general condition. Edema of both legs was severe, and laboratory findings (TP 5.0 g/dl, ALB 1.3 g/dl, T-Chol 369 mg/dl, proteinuria 3+) at the time of admission met the diagnosis criteria for NS rather than cachexia. We first administered albumin to stabilize circulation, and started treatment with prednisolone and cyclosporine, which greatly improved her general condition and edema of her legs. Subsequently, NS repeatedly improved and worsened and the tumors gradually progressed. The patient died of multiple organ failure induced by disseminated intravascular coagulation (DIC) at 81 days after admission. NS caused by malignancy is not uncommon. In general, however, such cases of NS are associated with solid tumors, such as gastrointestinal and lung cancer. NS caused by uterine cancer is very rare. We suggest that NS should be borne in mind in addition to cachexia, hypo-proteinemia or lymphedema as a possible cause of edema in the end stage of advanced cancer. Palliat Care Res 2011; 6(1): 316-323

A discussion on a education method for basic bacteriology for medical students with computers / 医学教育

A series of basic questions on medical bacteriology for the 1st grade of medical students was prepared on computer display (computer quiz). This computer quiz consists of 163 short sentences with either right or wrong content. Students can challenge the computer quiz as many times as they wish whenever students are free from their formal curriculum. A printed list of questions and their answers was handed to students in advance because the computer quiz was opened to students in advance of concomitant lectures and students had no previous knowledge on which they might relied. This computer quiz might serve not only as an alternative of conventional methods for evaluation of progress in students' studies but also as a convenient tool to let medical students efficiently memorize the outlined index for basic bacteriology.